Utilization Review Nurse- Remote

Mindlance; Town of Texas (WI); On-site; USD 56,481 - 62,680; Full time

Job summary

A staffing firm is seeking a Nurse Case Management Senior Analyst. Responsibilities include planning, implementing, and evaluating healthcare services. Applicants must hold an active RN license and have experience with MCG/InterQual. This role is offered remotely for residents in selected states, ensuring quality care for members through clinical evaluations and support.

Qualifications

• Active, current, and unrestricted Registered Nurse (RN) license required.
• Must have MCG/InterQual experience.
• Experience in case management, utilization review, or clinical coordination preferred.

Responsibilities

• Perform clinical assessments to determine member needs.
• Plan, coordinate, and evaluate care services to support positive health outcomes.
• Manage an independent caseload and coordinate all assigned cases.

Skills

Assessment skills

Planning skills

Evaluation skills

MCG/InterQual experience

Education

Active, unrestricted RN License

Job description

This range is provided by Mindlance. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$41.00/hr - $45.50/hr

Direct message the job poster from Mindlance

Connecting Top IT Talent with Direct Government Clients

Role: Nurse Case Management Senior Analyst

Location: Remote (within plan states: IL, TX, NM, OK, MT, TN)

Remote only for residents of IL, TX, NM, OK, MT, and TN.

License Required: Active, unrestricted RN License

Must have MCG/InterQual experience.

Job Summary:

The Nurse Case Management Senior Analyst is responsible for planning, implementing, coordinating, monitoring, and evaluating healthcare services for members in alignment with physician treatment plans. The role ensures cost-effective, high-quality care and supports members through clinical assessments, health education, and utilization management.

Key Responsibilities:

• Perform clinical assessments to determine member needs.
• Plan, coordinate, and evaluate care services to support positive health outcomes.
• Conduct prospective, concurrent, and retrospective reviews for inpatient, rehab, referrals, and select outpatient services.
• Manage an independent caseload and coordinate all assigned cases.
• Support program objectives by assessing the effectiveness of alternative care options.
• Provide health education and utilization management oversight.
• Address complex issues escalated from junior team members.
• Complete day-to-day tasks with minimal supervision.

Requirements:

• Active, current, and unrestricted Registered Nurse (RN) license
• Must have MCG/InterQual experience.
• Experience in case management, utilization review, or clinical coordination preferred.
• Strong assessment, planning, and evaluation skills.
• Ability to work independently and anticipate member needs.
• Must reside in IL, TX, NM, OK, MT, or TN.

About Us:

Founded in 1999, Mindlance is a certified diversity business (MBE) and has been ranked one of the fastest growing U.S staffing firms by SIA for ten years. Mindlance has been recognized as one of the consistently best performing partners to industry-leading MSP programs including Kelly, TAPFIN, Allegis, Magnit, Pontoon, Monument, Guidant and Agile-1.

As a recruitment-centric talent acquisition company, Mindlance provides Technology, Engineering, Scientific, Clinical Research, Digital, Creative, Marketing, Professional & Call-center staffing as well as Direct Sourcing, RPO, Global Payroll IC management workforce solutions to enterprise clients. With an annual revenue of over $400 million and growing, the Mindlance story is one of calculable achievement, made meaningful by the commitment to keep getting better in a way that is mindful and creates a balance that works for everyone.

EEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.